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. 2012 Apr 15;205(2):252-7.
doi: 10.1016/j.jneumeth.2012.01.009. Epub 2012 Jan 24.

Multi-modal pain measurements in infants

A Worley  1 , L Fabrizi, S Boyd, R Slater
Affiliations

Multi-modal pain measurements in infants

A Worley et al. J Neurosci Methods. .

Abstract

A non-invasive integrated method was developed to measure neural and behavioural responses to peripheral sensory and noxious stimulation in human infants. The introduction of a novel event-detection interface allows synchronous recording of: (i) muscle and central nervous system activity with surface electromyography (EMG), scalp electroencephalography (EEG) and near-infrared spectroscopy (NIRS); (ii) behavioural responses with video-recording and (iii) autonomic responses (heart rate, oxygen saturation, respiratory rate and cardiovascular activity) with electrocardiography (ECG) and pulse oximetry. The system can detect noxious heel lance and touch stimuli with precision (33 μs and 624 μs respectively) and accuracy (523 μs and 256 μs) and has 100% sensitivity and specificity for both types of stimulation. Its ability to detect response latencies accurately was demonstrated by a shift in latency of the vertex potential of 20.7 ± 15.7 ms (n=6 infants), following touch of the heel and of the shoulder, reflecting the distance between the two sites. This integrated system has provided reliable and reproducible measurements of responses to sensory and noxious stimulation in human infants on more than 100 test occasions.

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Figures

Fig. 1
Fig. 1
(A) Lancet used for the heel lance; (B) modified tendon hammer used for tactile stimulation.
Fig. 2
Fig. 2
Block diagram of the event detection interface used for detecting blade release from the lancet (upper section), or the delivery of tactile stimuli (lower section). Mode of event marking is determined by the switch.
Fig. 3
Fig. 3
Simultaneous and synchronised acquisitions of video (behavioural activity); EEG (CPz only), total haemoglobin concentration [HbT] and EMG (central nervous system activity); respiration, heart rate, ECG and oxygen saturation (autonomic activity) in correspondence of non-noxious touch (A) and noxious lance of the heel (B). (Note: example traces were not all recorded in the same infant.)
Fig. 4
Fig. 4
(A) ERP elicited by tapping the shoulder or the heel; (B) the latency of the ERP elicited by tapping the shoulder is shorter than by tapping the heel.
See this image and copyright information in PMC

References

    1. Bromm B., Scharein E. Principal component analysis of pain-related cerebral potentials to mechanical and electrical stimulation in man. Electroencephalogr Clin Neurophysiol. 1982;53:94–103. - PubMed
    1. Duhn L.J., Medves J.M. A systematic integrative review of infant pain assessment tools. Adv Neonatal Care. 2004;4:126–140. - PubMed
    1. Fitzgerald M., Walker S.M. Infant pain management: a developmental neurobiological approach. Nat Clin Pract Neurol. 2009;5:35–50. - PubMed
    1. Hrbek A., Hrbkova M., Lenard H.G. Somato-sensory evoked responses in newborn infants. Electroencephalogr Clin Neurophysiol. 1968;25:443–448. - PubMed
    1. Hrbek A., Karlberg P., Olsson T. Development of visual and somatosensory evoked responses in pre-term newborn infants. Electroencephalogr Clin Neurophysiol. 1973;34:225–232. - PubMed

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